| NPI | 1578828703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: TX S2006) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX S2006) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-07-01 |